The DOI matches its Crossref record; 116 of the 116 references it cites were found in a registry or an index.
Effects of abstinence from tobacco: Etiology, animal models, epidemiology, and significance: A subjective review
Abstract
This article updates a 1990 review of the effects of tobacco abstinence by reviewing (a) the etiology, (b) animal models, (c) the epidemiology, and (d) the clinical significance of tobacco abstinence effects. The author searched several databases to locate more than 3,500 citations on tobacco abstinence effects between 1990 and 2004. For brevity, the review does not evaluate these effects in regard to craving, hunger, or performance. Data collection and study conclusions were based on the author's subjective judgment. The most validated etiological model suggests that withdrawal is related to decreased dopaminergic activity, but how this relates to nicotine receptor changes is unclear. The two most validated animal models describe increases in intracranial self-stimulation thresholds or observable physical signs. Significant withdrawal symptoms occur in at least half of smokers when they try to quit. Withdrawal appears to produce clinically significant distress and impairment. Increases in depression after abstinence, but not other symptoms, prospectively predict relapse. In conclusion, the proposed neurobiological mechanisms by which withdrawal occurs leave several unanswered questions. Although animal models have been developed, how well they mimic withdrawal in humans is unclear. Tobacco withdrawal is common and can be distressing. Withdrawal-induced depression appears to undermine the smoker's ability to remain abstinent.
Overview
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In the citing paper
“In addition to this, chronic changes in the CNS lead to unpleasant withdrawal symptoms (irritability, depressed mood, anxiety, restlessness, difficulty concentrating and increased appetite) that make the experience of not smoking aversive and generate the need to smoke (19,20).”
From The Multiple Facets of Cigarette Addiction and What They Mean for Encouraging and Helping Smokers to Stop (2009) · cites this paper as [19]
In the citing paper
“Of these, depressed mood early on in the quit attempt appears to be the one most strongly associated with relapse (19)”
From The Multiple Facets of Cigarette Addiction and What They Mean for Encouraging and Helping Smokers to Stop (2009) · cites this paper as [19]
In the citing paper
“It has also been found that chronic financial stress (26) and depression (19), which deplete mental energy are associated with greater risk of relapse.”
From The Multiple Facets of Cigarette Addiction and What They Mean for Encouraging and Helping Smokers to Stop (2009) · cites this paper as [19]
Citations
Cites
Diagnostic and Statistical Manual of Mental Disorders
Williams, J. B. W., & First, M. B. (2013) · Oxford University Press eBooks · doi:10.1093/acrefore/9780199975839.013.104 · Cited by 109,845
Pharmacological interventions for somatoform disorders in adults
Kleinstäuber, M., Witthöft, M., Steffanowski, A., van Marwijk, H., Hiller, W., & Lambert, M. J. (2014) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd010628.pub2 · Cited by 11,369
Drug Addiction, Dysregulation of Reward, and Allostasis
Koob, G. (2001) · Neuropsychopharmacology · doi:10.1016/s0893-133x(00)00195-0 · Cited by 2,953
McNair, D. M. (1992) · Medical Entomology and Zoology · Cited by 2,527
Addiction motivation reformulated: an affective processing model of negative reinforcement
Baker, T. B., Piper, M. E., McCarthy, D. E., Majeskie, M. R., & Fiore, M. C. (2004) · Psychological Review · doi:10.1037/0033-295x.111.1.33 · Cited by 2,162
Signs and Symptoms of Tobacco Withdrawal
Hughes, J. R. (1986) · Archives of General Psychiatry · doi:10.1001/archpsyc.1986.01800030107013 · Cited by 1,669
Self-citationA cognitive model of drug urges and drug-use behavior: role of automatic and nonautomatic processes
Tiffany, S. T. (1990) · Psychological Review · doi:10.1037/0033-295x.97.2.147 · Cited by 1,554
Research Advances in Alcohol and Drug Problems
Smart, R. G., Cappell, H., Glaser, F. B., Israel, Y., Kalant, H., Popham, R. E., Schmidt, W., & Sellers, E. M. (1984) · Springer eBooks · doi:10.1007/978-1-4613-2719-6 · Cited by 1,114
Best evidence synthesis: An intelligent alternative to meta-analysis
Slavin, R. E. (1995) · Journal of Clinical Epidemiology · doi:10.1016/0895-4356(94)00097-a · Cited by 951
Behavioral and Neural Analysis of Extinction
Myers, K. M., & Davis, M. (2002) · Neuron · doi:10.1016/s0896-6273(02)01064-4 · Cited by 918
Flagged first, then by citations
Cited by
Sorted by citations
Items 101–173 of 173
Weight Change in Patients Attempting to Quit Smoking Post-myocardial Infarction
Grandi, S. M., Filion, K. B., Gervais, A., Joseph, L., O’Loughlin, J. L., Paradis, G., Rinfret, S., Pilote, L., Grondin, F. R., Lutchmedial, S. R., et al. (2014) · The American Journal of Medicine · doi:10.1016/j.amjmed.2014.02.032 · Cited by 10
Barakat, M. M., Alqudah, R., Alfayoumi, I. N., Al-Obaidi, H. J., Jirjees, F., & Basheti, I. A. (2021) · Addiction Science & Clinical Practice · doi:10.1186/s13722-021-00219-9 · Cited by 9
The Translational Research Working Group Developmental Pathway for Lifestyle Alterations
Hawk, E. T., Greenwood, A., Gritz, E. R., McTiernan, A., Sellers, T., Hursting, S. D., Leischow, S. J., & Grad, O. (2008) · Clinical Cancer Research · doi:10.1158/1078-0432.ccr-08-1262 · Cited by 9
Xue, Y., Zhou, H., Jiang, C., Liu, X., Zhou, Z., & Wang, J. (2020) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2020.604684 · Cited by 8
Hou, L., Zhang, J., Liu, J., Chen, C., Gao, X., Chen, L., Zhou, Z., & Zhou, H. (2024) · Neuropsychiatric Disease and Treatment · doi:10.2147/ndt.s452795 · Cited by 7
Time‐varying effects of ‘optimized smoking treatment’ on craving, negative affect and anhedonia
Kim, N., McCarthy, D. E., Cook, J. W., Piper, M. E., Schlam, T. R., & Baker, T. B. (2020) · Addiction · doi:10.1111/add.15232 · Cited by 7
Harris, A. C. (2021) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2021.108870 · Cited by 6
Adverse physiological effects of smoking cessation on the gastrointestinal tract: A review
Mahyoub, M. A., Al-Qurmoti, S., Rai, A. A., Abbas, M. A., Jebril, M., Alnaggar, M., & He, S. (2023) · Medicine · doi:10.1097/md.0000000000035124 · Cited by 8
Knott, V., Bisserbe, J. C., Shah, D. K., Thompson, A. L., Bowers, H., Blais, C. M., & Ilivitsky, V. (2013) · Biological Psychology · doi:10.1016/j.biopsycho.2013.09.008 · Cited by 6
Duncan, P. M. (2020) · Cambridge University Press eBooks · doi:10.1017/9781139025515 · Cited by 8
Indicadores de síntomas de abstinencia en un grupo de fumadores mexicanos
Lara-Rivas, G., Ramírez‐Venegas, A., Sansores-Martínez, R. H., Espinosa, A. M., & Regalado-Piñeda, J. (2007) · Salud Pública de México · doi:10.1590/s0036-36342007000800016 · Cited by 5
Smoking Cessation After Brain Damage Does Not Lead to Increased Depression
Tranel, D., McNutt, A., & Bechara, A. (2012) · Cognitive and Behavioral Neurology · doi:10.1097/wnn.0b013e3182492a9c · Cited by 5
Abrams, K., Krimmel, S., Johnson, S., Cieslowski, K., Strnad, H. K., Melum, A., & Kryder, C. (2017) · Depression and Anxiety · doi:10.1002/da.22652 · Cited by 5
Chen, Y., & Li, C.-S. R. (2023) · Journal of Integrative Neuroscience · doi:10.31083/j.jin2203066 · Cited by 4
New Insights into the Development of Tobacco Dependence: A Review of Recent Research
DiFranza, J. R. (2012) · Pediatric Allergy Immunology and Pulmonology · doi:10.1089/ped.2012.0153 · Cited by 4
Effects of smoking and nicotine withdrawal on prospective memory
Rash, C. J. (2007) · Louisiana State University · doi:10.31390/gradschool_dissertations.3448 · Cited by 4
Does cigarette smoking effect the physical activity of the university students?
Soyuer, F. T., Ünalan, D., & Elmalı, F. (2011) · Kafkas Journal of Medical Sciences · doi:10.5505/kjms.2011.58066 · Cited by 3
Dowlati, Y., de Jesus, D. R., Selby, P. L., Fan, I., & Meyer, J. H. (2019) · Neuropsychiatric Disease and Treatment · doi:10.2147/ndt.s172334 · Cited by 3
Schnoll, R. A., Wileyto, E. P., Bauer, A., Fox, E. N., Leone, F. T., Lerman, C. E., Tyndale, R. F., George, T. P., Hawk, L. W., Cinciripini, P. M., et al. (2021) · American Journal on Addictions · doi:10.1111/ajad.13155 · Cited by 3
Keller-Hamilton, B. L., Sloan, R., Mehta, T. R., Hinton, A. M., Tackett, A. P., Roberts, M. E., Brinkman, M. C., & Wagener, T. L. (2024) · Addiction · doi:10.1111/add.16531 · Cited by 3
Laadraoui, J., Aboufatima, R., Ouarhach, A., Bezza, K., Gabbas, Z. E., Mehdi, A. L., Marhoume, F., Kebbou, A., & Chait, A. (2019) · Toxicological & Environmental Chemistry Reviews · doi:10.1080/02772248.2019.1628236 · Cited by 3
Hatsukami, D. K. (2007) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2007.08.002 · Cited by 3
Impact of Smoking and Smoking Cessation Medications in Aviators
Dailey, J. I., & Wilson, K. (2019) · Current Psychiatry Reports · doi:10.1007/s11920-019-1109-x · Cited by 1
Cigarette smoking after surviving breast cancer: A pilot study
Majeed, B., Ayyala, D. N., & Coughlin, S. S. (2021) · Current Cancer Reports · doi:10.25082/ccr.2021.01.008 · Cited by 2
Tobacco Addiction and Psychological Co-morbidities
Ziedonis, D. M., Kalman, D., Kolodziej, M. E., Johnson, C. W., & Kim, S. Y. (2011) · Springer eBooks · doi:10.1007/978-1-4419-0029-6_5 · Cited by 2
Peters, E. N., Cooney, J. L., Liss, T. B., Liss, A., Torello, R., Franco, C. A., Cavallo, D. A., O’Malley, S. S., & Krishnan‐Sarin, S. (2013) · The Journal of Smoking Cessation · doi:10.1017/jsc.2013.13 · Cited by 2
Sharp, B. M., Jiang, Q. L., Simeone, X., & Scholze, P. (2020) · ACS Pharmacology & Translational Science · doi:10.1021/acsptsci.0c00111 · Cited by 2
Mathew, A. R., Avery, E., Cox, C. M., Nwanah, P., Kalhan, R., Hitsman, B. L., & Powell, L. H. (2023) · Journal of Behavioral Medicine · doi:10.1007/s10865-023-00411-z · Cited by 2
The Unified Protocol for Smoking Cessation
Mathew, A. R., & Cox, C. M. (2023) · Oxford University Press eBooks · doi:10.1093/oso/9780197564295.003.0013 · Cited by 2
Delirium and Nicotine Withdrawal
Kataria, D. K., Ankit, G., Tiwari, S., & Kukreti, P. (2019) · Elsevier eBooks · doi:10.1016/b978-0-12-813035-3.00028-9 · Cited by 2
Energy poverty consequences of aggressive tobacco tax policies
Hadi, M., Petrie, D., & Khalil, U. (2026) · Social Science & Medicine · doi:10.1016/j.socscimed.2026.119002 · Cited by 1
Smoking cessation during pregnancy and the potential role of exercise: A narrative review
Nagpal, T. S., Fagan, M. J., & Harry Prapavessis, A. (2017) · Medical Research Archives · doi:10.18103/mra.v5i7.1413 · Cited by 1
Substance Use Disorders: A Biopsychosocial Perspective
Duncan, P. M. (2020) · ODU Digital Commons (Old Dominion University) · Cited by 1
Vujanovic, A. A. (2008) · ScholarWorks -A service of University of Vermont Libraries (University of Vermont)
The Role of Aftereffects and Withdrawal in Addiction
Kassel, J. D., Veilleux, J. C., Heinz, A. J., Braun, A. R., & Weber, S. (2013) · Wiley eBooks · doi:10.1002/9781118384404.ch11
Exploring Predictors of Relapse and Maintenance Among Smokers
Gökbayrak, N. S. (2013) · doi:10.23860/thesis-gokbayrak-n.-2013
Nada, A., Baxter, S., Loraas, E., & Somberg, J. C. (2008) · American Journal of Therapeutics · doi:10.1097/mjt.0b013e3181727c12
Emergent Cognitive Impairment During Early Nicotine Withdrawal ∗
Schuster, R. M., & Evins, A. E. (2016) · Elsevier eBooks · doi:10.1016/b978-0-12-802574-1.00015-6
Reckziegel, P. (2011) · Americanae (AECID Library)
Natural history of tobacco withdrawal: implications for smoking cessation treatment
McRobbie, H. J., & West, O. (2013) · doi:10.2217/ebo.12.262
Investigating Tobacco Withdrawal In Opioid-Maintained Smokers And Smokers With Other Vulnerabilities
Streck, J. M. (2020) · ScholarWorks -A service of University of Vermont Libraries (University of Vermont)
Smoking Cessation Interventions in Arab Populations: A Systematic Review
Abraham, K. (2019) · Carolina Digital Repository (University of North Carolina at Chapel Hill) · doi:10.17615/hmd4-qh60
Marshall, L. J. (2019) · UEA Digital Repository (University of East Anglia)
Time varying connectivity across the brain changes as a function of nicotine abstinence statePreprint
Fedota, J. R., Ross, T. J., Castillo, J., McKenna, M. R., Matous, A. L., Salmeron, B. J., Menon, V., & Stein, E. A. (2020) · bioRxiv (Cold Spring Harbor Laboratory) · doi:10.1101/2020.01.25.917617
Psychiatric Disorders, Personality, and Developmental Factors
Duncan, P. M. (2020) · Cambridge University Press eBooks · doi:10.1017/9781139025515.009
Duncan, P. M. (2020) · Cambridge University Press eBooks · doi:10.1017/9781139025515.015
Use Disorders of Cocaine and Methamphetamine
Duncan, P. M. (2020) · Cambridge University Press eBooks · doi:10.1017/9781139025515.014
Tranquilizers and Sedative Use Disorders
Duncan, P. M. (2020) · Cambridge University Press eBooks · doi:10.1017/9781139025515.016
Duncan, P. M. (2020) · Cambridge University Press eBooks · doi:10.1017/9781139025515.018
Duncan, P. M. (2020) · Cambridge University Press eBooks · doi:10.1017/9781139025515.001
The Biopsychosocial Perspective and Research Methods for Investigation of Substance Use Disorders
Duncan, P. M. (2020) · Cambridge University Press eBooks · doi:10.1017/9781139025515.002
Duncan, P. M. (2020) · Cambridge University Press eBooks · doi:10.1017/9781139025515.010
Duncan, P. M. (2020) · Cambridge University Press eBooks · doi:10.1017/9781139025515.004
Genetic Influence on Substance Use Disorders
Duncan, P. M. (2020) · Cambridge University Press eBooks · doi:10.1017/9781139025515.007
Brain Function and Substance Use Disorders
Duncan, P. M. (2020) · Cambridge University Press eBooks · doi:10.1017/9781139025515.006
Tobacco Use and Nicotine Addiction
Duncan, P. M. (2020) · Cambridge University Press eBooks · doi:10.1017/9781139025515.012
Behavioral, Cognitive, and Social Factors Promoting SUD
Duncan, P. M. (2020) · Cambridge University Press eBooks · doi:10.1017/9781139025515.008
Duncan, P. M. (2020) · Cambridge University Press eBooks · doi:10.1017/9781139025515.005
Diagnosis of Substance Use Disorders
Duncan, P. M. (2020) · Cambridge University Press eBooks · doi:10.1017/9781139025515.003
Duncan, P. M. (2020) · Cambridge University Press eBooks · doi:10.1017/9781139025515.011
Treatment of Substance Use Disorders
Duncan, P. M. (2020) · Cambridge University Press eBooks · doi:10.1017/9781139025515.017
Clarke, P. B. S. (2015) · Springer eBooks · doi:10.1007/978-3-642-36172-2_303
clarke, P. (2010) · Springer eBooks · doi:10.1007/978-3-540-68706-1_303
Clarke, P. B. S. (2014) · Springer eBooks · doi:10.1007/978-3-642-27772-6_303-3
Clarke, P. B. S. (2014) · Springer eBooks · doi:10.1007/978-3-642-27772-6_303-2
Health recommender systems for behavior change
Hors-Fraile, S. (2022) · Research Publications (Maastricht University) · doi:10.26481/dis.20220324sh
Weng, L.-Y., Syu, J.-N., Li, C., Wu, J., Lee, S.-C., Pan, A.-N., Kuo, C., Chen, C., Chou, Y.-T., Wu, C.-H., et al. (2025) · Health Promotion International · doi:10.1093/heapro/daaf186
Lee, E., Park, H., Lee, J.-H., Kim, H., Park, H. J., Joh, H., & Ahn, W. (2025) · bioRxiv (Cold Spring Harbor Laboratory) · doi:10.1101/2025.11.18.688678
Barakat, M. M., Alqudah, R., Alfayoumi, I., Al-Obaidi, H. J., Jirjees, F., & Basheti, I. A. (2021) · Figshare · doi:10.6084/m9.figshare.13725269
Metadata
- Authors
- Hughes, J.
- Affiliations
- University of Vermont (US)
- Corresponding author
- Hughes, John
- Venue
- Nicotine & Tobacco Research
- Publisher
- Oxford University Press (OUP)
- Published
- 2007-03
- Volume
- 9
- Issue
- 3
- Pages
- 329-339
- ISSN
- 1462-2203 (ISSN-L)
- OpenAlex
- W2100829515
- Semantic Scholar
- b62e71eeaaa699df395760582dbbf7df27b7e55e
- Cited by
- 173
- References
- 116
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 3 · 2023: 5 · 2022: 3 · 2021: 6 · 2020: 36 · 2019: 6 · 2018: 4 · 2017: 6 · 2016: 7 · 2015: 10 · 2014: 12 · 2013: 10 · 2012: 7
- FWCI
- 8.01
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Nicotine & Tobacco Research (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute on Drug Abuse (DA00490)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Smoking Behavior and Cessation
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Nicotinic Acetylcholine Receptors Study
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Prenatal Substance Exposure Effects
- Keywords
- smoking abstinence, nicotine withdrawal, smoking cessation, withdrawal symptoms, depression, relapse, dopaminergic activity, nicotinic acetylcholine receptors, intracranial self-stimulation
- MeSH terms
- Animals, Mental Disorders, Disease Models, Animal, Humans, Nicotine, Research Design, Substance Withdrawal Syndrome, Tobacco Use Disorder, Randomized Controlled Trials as Topic, Smoking Cessation
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
